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<br /> rte!! r .. P'UBLTC RECORDS"LEASE "PLICATION ��
<br /> t APPLICANT /,PAJ lrL� Y{��h h �j
<br /> # A[lt]RE33: BUSINESS/AGENCY: .UC.I�-2Clcrr ,piL�
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<br /> PHONE(1):_. 12 5 7.� -3 PHONE 2 /�.� 2-{ )• -�—,� _J ^��:. FACSIIIA ISE: �'�_`5 �!�-"arO G
<br /> TENTATIVE*APPOINTMENT DATE: --jam 7 Time: -10.r 30 A,M_ F
<br /> (please allow 10 business days from date of application submittal-+Tanta{ive only-must be confirmed)
<br /> i M CHECK SOX`ro EXPEDITE,REQUEST--x$3.00,FEE(CASH OR CHECK ONLY►-RE01M1 PRMES&ED IN 3 BU51NE55 DAYS
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<br /> SIGNATURE OF APPLICANTf� f DATE J G7
<br /> UNIT DISTRJBU71ON ❑ Unit 1 ❑ Unit 2 ❑ UM S O Unh 4 ❑ Unit 5 ❑ Unit 6 y' ❑ Other(eiectronlenistslmaps)
<br /> FILE ADDRESS
<br /> street street Name clty a EHD USE ONLY
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<br /> Specific Date Range of Information Requested:From
<br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES
<br /> i MUNDERGROUN4 TANK(UST)CLEANUP SITE(LOP) Q Houww ABATEMENT ❑$0130 WASTE EAgLITYf VEI(ICLE
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<br /> { 04 OTHER CLEANUP SITE(NON-Lap) 0 FORD FAciuTY ;d O WASTETMRE
<br /> UNDERGROUND TANK(MONITORINGIREmovAL) ❑ooc KENNP- " ©Dam•
<br /> F+HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH 0 WA5T16WATm TREATMENT PLANT
<br /> V TIERED PEAMnTED FACILITY ❑MOTLLJHOTEL L]PUM::MTRUCKIYARDICHHM TOMEM
<br /> L7 YArrgOISOpY P1EFtGING ❑POOLISPA I ❑LAND USE APKICATION SITES
<br /> 13 ellE",DICAL WA$TE FACILITY 0 OTHER(PLEASE SPECIFY)
<br /> WELL AND SEPTIC PERMIT REGARDS ARE AVAILA9LE FOR RWEW. MONOAY•FRIDAY$:00 AM-6:00pM - EXCLUDING HOLIDAYS.
<br /> 1. List up to ten addresses In the space above. Select the type(s)of files from the list above by checking the
<br /> { -appropriate box(es). At least one file type MUST be selected. Fax to 208 464'-0138 or mail to the address
<br /> indicatedabove. Address ranges will not be accepted—for additional assistance with file addresses,contact
<br /> the EHD.Applications receiver[ after 3;00 pm will be processed the next business day.
<br /> 2. The EHp will notify the applicant if any EHD files exist. An appointmentfor review will be confirmed
<br /> approximately ten (1 e)days after receipt of application. The files will be held for a maximum of five business '
<br /> days for review. Appointments should be scheduled accordingly.
<br /> 3. A file that Is actively being worked on by EHO staff may not be immediately available for review. A new
<br /> application may be submitted when the file is available.
<br /> 4. At,y file not returned in the same condition as released will be reorganized by EHD staff at the expense of the
<br /> applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to review, -
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